Register for the Fine Arts Club

FINE ARTS CLUB REGISTRATION FORM

Name of child:*
Email Address*
Birthday*
Has your child ever participated in nonparented classes and/or activities? YES/NO*
If yes, please elaborate:
What days will your child be attending?*
If one day- which day? Mon, Tues, Wed, Thurs OR Fri 2 days- Tues and Thurs 3 days- Mon, Wed, Fri
Does your child have any allergies or health conditions? YES/NO*
If yes, please elaborate:
Does your child have any special needs or sensitivities we can help them with?*
If yes, please elaborate:
Is your child potty trained? YES/NO*
The child must be potty trained to attend.
What is the best number to reach you at?*
What is an alternative emergency contact number (other than yourself)?
Are you open to receiving feedback about your child? YES/NO*
How did you hear about the Fine Arts Program?*
What is your expectations of the program?*
Consent*
I understand that Pivot Dance School is not a preschool or daycare and before and after care is not provided. We are a Fine Arts Club offering dance, yoga, fitness, music, arts and drama for kids 3-5 years of age. I confirm the information above is accurate and correct.
Parents Name*
First Last
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Phone
This field is for validation purposes and should be left unchanged.